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Chopsticks, Drumsticks, Forks, and Knives ...

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Keep your kids away from the following sharp objects!

kid holding chopsticks

Dr. Nina Shapiro: Many of us have heard about the young boy in China who accidentally fell on a chopstick, which impaled his nose and brain. He was transported for half a day until a neurosurgeon removed it successfully. But by the time the neurosurgeon saw him, he was nearly comatose from the brain injury.

Since I spend part of my time worried about my own children's safety with utensils, toys, sticks, and stones, and the other part of my time treating such injuries that children sustain, I thought this would be a good time to bring up why these objects can cause so much damage.

As ear, nose, and throat surgeons, we often refer to the face as the "bumper to the brain." This is so. The nose, cheeks, eyes, and mouth protect the brain from injuries when we fall, break our nose or jaw, or even chip a tooth. The face works best as a bumper for "blunt" injuries, such as falls, getting hit with a ball, or even when smashing into a windshield or airbag during a car accident. But this isn't the case for sharp, "penetrating" injuries, such as from chopsticks.

Many people are surprised to learn that the nose is remarkably close to the brain. The top of the nose has a paper-thin plate of bone that separates it from the front of the brain. Penetrating through this roof can lead to uncontrollable bleeding into the brain, progressing to stroke and even death. It can also expose the brain to bacteria from the nose, leading to meningitis (infection of the lining of the brain), or encephalitis (infection of the brain tissue itself). The roof of the mouth, or palate, is also quite close to the brain, and has branches of large blood vessels (the carotid arteries) which supply blood to the brain. Sharp injury to the palate can injure the carotid arteries, leading to life-threatening bleeding, or even stroke.

Despite all the safety labeling in the world, children (and rarely, adults) sustain penetrating injuries from sharp objects. The obvious are scissors, knives, and forks with sharp tines, and less obvious are chopsticks, drumsticks, and even firm plastic straws, the latter of which I am not a fan. Even if your child is not running, straws (the very soft ones on sippy cups are fine) should not be allowed unless seated calmly, and should never be used in the car while you're driving. Sudden stops can lead to a palate impalement, even in a calmly seated child. If such an event does happen, and the object remains lodged (be it the nose, palate, or even eye), do as the family in China did. Do not remove it, tempting as it may be, and upset as you and your child will most definitely be. The object will act as a temporary barrier to infection and bleeding. Go to the closest emergency room, or -- if your child is not in distress -- to an emergency room with a children's department. Even if it is a seemingly minor injury, don't be surprised if it is recommended to have your child monitored, even overnight, for any neurological changes. Sometimes a brain CT scan or blood vessel evaluation (angiogram) are recommended, but usually only in severe injuries.

For now, let them pick up their sushi with their fingers, and spill some of their drink in the backseat. It never hurt anyone.

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2 comments so far | Post a comment now
Robyn January 20, 2010, 6:23 AM

I have a real problem with this article, and that is that the author makes no age distinctions. Should we keep 5-year-olds away from forks? Ten-year-olds away from chopsticks? Teenagers away from straws?

You can’t say we should rely on common sense when the whole article argues that our common sense (like giving straws to toddlers) is wrong.

The real lesson is not so much that we should keep sharp pointy things away from kids of all ages, but that kids should have access to them only when they are able to carry them safely (walking with the point down), or when (as the article briefly mentioned toward the end) when they are calm and seated. Part of parenting is teaching children to take their own safety precautions, because we can’t bubble-wrap them forever.

airway January 20, 2010, 12:50 PM

Great points (no pun intended…). Indeed, this article was focused more on toddlers, who are at much higher risk for these injuries. Of course an older child (four or five, or even a very calm three year old) is more than capable of appropriately handling forks, knives, scissors, and chopsticks.
The ‘point’ of the article was really to alert people that these injuries do exist, and how/what damage they can do.
And my six-year-old daughter loves to use chopsticks.

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